Form Dwc-1a - Wage Statement Reporting Instructions printable pdf download

Form Dwc-1a - Wage Statement Reporting Instructions

WAGE STATEMENT REPORTING INSTRUCTIONS

General:

Florida law requires disabled employees to be compensated at a certain

percentage of their average weekly wage.

If the injured employee worked during

substantially the whole of 91 days immediately preceding the injury, the employee’s

average weekly wage is one-thirteenth of the total amount of wages earned during the 91

day period. “Substantially the whole of 91 days” means a consecutive period of 91 days,

not less than 90% of the total customary full-time hours of employment during that period.

Reporting Gross Pay: Complete all columns; as applicable. Report the actual gross

earnings of the injured employee for the consecutive 91 day period immediately preceding

the accident. The 91 day period includes Saturdays, Sundays, holidays, and other non-

working days. Wages for the first and/or last week(s) (No. 1 and 14 on the form) may be

represented by a partial calendar work week(s) if the employee was injured, for example,

during the middle of the work week. Remember to include all overtime and any bonuses

paid during the 91 day period. If the injured employee was not employed for you for

approximately 82 days during that period, enter the wages of a similar employee in the

same employment who was employed for approximately 82 days of the 91 day period. Do

not combine wages for two or more employees to yield wages for the 91 days.

Reporting Gratuities & Fringe Benefits: Gratuities reported should include only those

gratuities reported to the employer in writing as taxable income received in the course of

employment from others than the employer. The reportable value of a fringe benefit is the

actual cost to the employer for the benefit furnished. The only fringe benefits that can be

included for dates of accident occurring on or after 07/01/90 are employer contributions

for health insurance for the employee or the employee’s dependents, and the reasonable

value of housing furnished to the employee by the employer which is intended as the

permanent year-round housing of the employee.

LES FORM DWC-1a (11/96)

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Form Dwc-1a - Wage Statement Reporting Instructions